community medicine and teaching methadology presentation.pptx

Community medicine presentation

1. SPINA BIFIDA Ayesha ID: 12555

2. SPINA BIFIDA : Spina bifida is a birth defect that occurs when the spine and spinal cord don’t form properly. It is also called neural tube defect. The neural tube is the precursor for the child’s brain and spinal cord. In spina bifida a part of the neural tube fails to develop and this leads to defects in the spinal cord and spine. Around 1, 400 Babies are born with spina bifida in U. S every year .

3. TYPES : SPINA BIFIDA OCCULTA : It is a defect which result from failure of formation of bony arch around the spinal cord, but spinal cord and meninges are normal. It is not visible externally. SPINA BIFIDA CYCSTICA : It is a defect in the closure of posterior vertebral arch with protrusion of spinal cord and meninges through the defect. a) Meningocele: It is a sac like herniation through the bony malformation, containing meninges and cerebrospinal fluid. b) Myelomenigocele: It is a sac like protrusion of spinal cord, CSF and meninges through spinal cleft. It is mostly found in lumbar or lumbosacral region.

4. CAUSES : Folic acid deficiency . Diabetes. Obesity. Genetic factor. Some medicine like anti-seizure(valproic acid) . COMPLICATIONS : Depends on the severity of the defect; Walking problems due to muscle weakness and sometimes paralysis. Orthopedic problems like scoliosis, dislocation of hip and contractures due to muscle weakness. Bowel and bladder problems due to damage to concerned nerves. Hydrocephalus and chiari malformations are associated disorder.

5. DIAGNOSIS : During pregnancy: Maternal serum alpha fetoprotein test: abnormally high level of alpha fetoprotein in the serum suggests a likely hood of neural tube defect. Abdominal ultrasound scan to see for features of neural tube defects. Amniocentesis: drawing fluid from the sac around the baby in the womb and to estimate the AFP levels. High levels suggest a neural tube defect. PREVENTION : Dietary supplements with folic acid has been shown to be helpful in reducing the incidence of spina bifida. Sources of folic acid include whole grains, fortified breakfast cereals, dried beans, leaf vegetables and fruits. It is recommended that any woman considering becoming pregnant take 0.4 mg of folic acid a day. Pregnant women need 1 mg per day

6. TREATMENT: The mildest forms of spina bifida may need no treatment. The main treatment for more serious types is surgery.  Fetal surgery.  Doctors can operate on some babies while they're still in the womb. Before the 26th week of pregnancy, the surgeon may be able to sew shut the opening over the baby's spinal cord. Newborn surgery.  Another option is surgery shortly after birth, often in the first 24-48 hours. If the baby has meningocele, the surgeon will put the membrane around the spinal cord back in place and close the opening. If the baby has myelomeningocele, the surgeon will put the tissue and spinal cord back inside the baby's body and cover it with skin